Evidence map›Paper›PMID 37395975›Full record

SynthesisJournal of neuro-oncology2023

Hippocampal avoidance in whole brain radiotherapy and prophylactic cranial irradiation: a systematic review and meta-analysis.

Sandra Leskinen, Harshal A Shah, Beril Yaffe, Shonna J Schneider, Netanel Ben-Shalom, John A Boockvar, Randy S D'Amico, A Gabriella Wernicke

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Whole-brain radiotherapy with simultaneous integrated boost in treatment of patients with brain metastases: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Sandra LeskinenState University of New York Downstate Medical Center, Brooklyn, NY, USA.
Harshal A ShahZucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
Beril YaffeDepartment of Neurology, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA.
Shonna J SchneiderDepartment of Neurology, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA.
Netanel Ben-ShalomDepartment of Neurological Surgery, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA.
John A BoockvarDepartment of Neurological Surgery, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA.
Randy S D'AmicoDepartment of Neurological Surgery, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA.
A Gabriella WernickeDepartment of Radiation Oncology, Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, NY, USA. gwernicke@northwell.edu.
Lenox Hill Hospital · USNeurological Surgery · USHofstra University · USState University of New York · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe systematically reviewed the current landscape of hippocampal-avoidance radiotherapy, focusing specifically on rates of hippocampal tumor recurrence and changes in neurocognitive function.

methodsPubMed was queried for studies involving hippocampal-avoidance radiation therapy and results were screened using PRISMA guidelines. Results were analyzed for median overall survival, progression-free survival, hippocampal relapse rates, and neurocognitive function testing.

resultsOf 3709 search results, 19 articles were included and a total of 1611 patients analyzed. Of these studies, 7 were randomized controlled trials, 4 prospective cohort studies, and 8 retrospective cohort studies. All studies evaluated hippocampal-avoidance whole brain radiation treatment (WBRT) and/or prophylactic cranial irradiation (PCI) in patients with brain metastases. Hippocampal relapse rates were low (overall effect size = 0.04; 95% confidence interval [0.03, 0.05]) and there was no significant difference in risk of relapse between the five studies that compared HA-WBRT/HA-PCI and WBRT/PCI groups (risk difference = 0.01; 95% confidence interval [- 0.02, 0.03]; p = 0.63). 11 out of 19 studies included neurocognitive function testing. Significant differences were reported in overall cognitive function and memory and verbal learning 3-24 months post-RT. Differences in executive function were reported by one study, Brown et al., at 4 months. No studies reported differences in verbal fluency, visual learning, concentration, processing speed, and psychomotor speed at any timepoint.

conclusionCurrent studies in HA-WBRT/HA-PCI showed low hippocampal relapse or metastasis rates. Significant differences in neurocognitive testing were most prominent in overall cognitive function, memory, and verbal learning. Studies were hampered by loss to follow-up.

Indexed as

Brain NeoplasmsNeoplasm Recurrence, LocalCranial IrradiationHippocampusHumansProspective StudiesRetrospective StudiesBrain tumorHippocampal avoidanceHippocampusNeurocognitive functionOrgans at riskRadiation

Identifiers

PMID37395975
OpenAlexW4382919490

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.